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Objectives <p>The aim of this study was to present the long-term outcomes of arthroscopic treatment for the rare condition of massive rotator cuff tears (MRCT) with coexisting posterior dislocation of the long head of the biceps tendon (PDLHBT).</p> Methods <p>The results of four male patients, with an average age of 56.5&#xa0;years at surgery, who were operated on between 2011 and 2022 for pseudoparalytic shoulder with MRCT and PDLHBT were analyzed retrospectively. All patients underwent arthroscopic LHBT tenotomy and partial (two&#xa0;patients) or complete (two patients) rotator cuff repair. Preoperative and postoperative clinical results were retrospectively evaluated: range of motion (ROM), pain assessed with the Visual Analog Scale (VAS) and function with the Subjective Shoulder Value (SSV), and Simple Shoulder Test (SST).</p> Results <p>The mean follow-up time was 8&#xa0;years (32–162&#xa0;months). Preoperative clinical results were poor: mean VAS&#xa0;6 (2–9); SSV 20% (10–30%); SST 8.3% (0–16.7%); shoulder ROM—forward flexion 45° (10°–90°), abduction 35° (10°–60°), external rotation (−30°–10°). At the final follow-up visit, patients reported good postoperative subjective outcomes despite poor ROM. All patients had a&#xa0;VAS of 0, mean SSV of 72.5% (60%–85%), and mean SST of 77% (66.7%–83.3%). Mean ROM was 125° (80°–160°), 120° (80°–150°), and 20° (0°–30°), respectively; thus the mean improvement was 80°, 85°, and 20°, respectively.</p> Conclusion <p>Posterior dislocation of the LHBT associated with MRCT is a&#xa0;challenging injury. Arthroscopic treatment significantly improved pain and functional outcomes; however, patients demonstrated only limited improvement in shoulder ROM.</p> Level of Evidence <p>IV</p>

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A rare shoulder injury: massive rotator cuff tear with posterior dislocation of long head of the biceps tendon

  • 期刊论文

  • 发表日期：

    2025年11月11日

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  • Bartłomiej Kordasiewicz,
  • Paweł Norwa,
  • Michał Janyst,
  • Maciej Otworowski,
  • Wojciech Ananicz,
  • Dariusz Grzelecki

摘要

Objectives

The aim of this study was to present the long-term outcomes of arthroscopic treatment for the rare condition of massive rotator cuff tears (MRCT) with coexisting posterior dislocation of the long head of the biceps tendon (PDLHBT).

Methods

The results of four male patients, with an average age of 56.5 years at surgery, who were operated on between 2011 and 2022 for pseudoparalytic shoulder with MRCT and PDLHBT were analyzed retrospectively. All patients underwent arthroscopic LHBT tenotomy and partial (two patients) or complete (two patients) rotator cuff repair. Preoperative and postoperative clinical results were retrospectively evaluated: range of motion (ROM), pain assessed with the Visual Analog Scale (VAS) and function with the Subjective Shoulder Value (SSV), and Simple Shoulder Test (SST).

Results

The mean follow-up time was 8 years (32–162 months). Preoperative clinical results were poor: mean VAS 6 (2–9); SSV 20% (10–30%); SST 8.3% (0–16.7%); shoulder ROM—forward flexion 45° (10°–90°), abduction 35° (10°–60°), external rotation (−30°–10°). At the final follow-up visit, patients reported good postoperative subjective outcomes despite poor ROM. All patients had a VAS of 0, mean SSV of 72.5% (60%–85%), and mean SST of 77% (66.7%–83.3%). Mean ROM was 125° (80°–160°), 120° (80°–150°), and 20° (0°–30°), respectively; thus the mean improvement was 80°, 85°, and 20°, respectively.

Conclusion

Posterior dislocation of the LHBT associated with MRCT is a challenging injury. Arthroscopic treatment significantly improved pain and functional outcomes; however, patients demonstrated only limited improvement in shoulder ROM.

Level of Evidence

IV